The Harry S. Truman Building, headquarters for the State Department, is seen in Washington. (Scott Applewhite/AP) (J. Scott Applewhite/ASSOCIATED PRESS)

Staff members at the U.S. Embassy in Baghdad were without emergency pain medication for more than a year as the State Department blamed a contractor and both tangled with Iraqi bureaucracy.

Then, for reasons unknown, U.S. and company officials dropped the issue.

Paramedics assigned to the embassy “do not possess the medications needed to render aid to severely injured personnel,” according to a report by the department’s Office of Inspector General (OIG). “Specifically, the medications required but not available are Ketamine, Diazepam, Midazolam, Morphine, and Oxycodone.”

State’s Bureau of Diplomatic Security (DS) blamed Triple Canopy, a private firm hired to provide “protective movement security services,” including paramedics, in Baghdad. The firm has a five-year $812 million contract that began Oct. 12, 2016.

The bureau “takes the position that it is primarily Triple Canopy’s contractual responsibility to obtain the medications,” according to the inspector general’s report.

Yet, the department’s Foreign Affairs Handbook, says “ ‘where necessary [State] will facilitate importation of medication,’ ” the inspector general noted. “OIG concludes that this is a circumstance in which such facilitation is ‘necessary.’ ”

Complicating the situation are Iraqi government regulations that do not allow private companies to bring certain medicine into the country.

After reading the OIG’s draft report, bureau officials agreed with its recommendation to facilitate acquisition of the medication. They said they would use the department’s diplomatic pouch services to ship the drugs to Baghdad and expected the first shipment to arrive in July. But when the report was issued this month, OIG said it was awaiting documentation that the medicine was indeed there.

Asked if the medication is now fully stocked, a State Department statement said “Embassy Baghdad’s response teams are prepared to support the immediate medical needs of the Mission.” Pressed to be more specific about the availability of the medicine, a second statement was a bigger dodge: “The Department of State does not comment on ongoing operational issues potentially regarding the safety and security of personnel.”

The inspector general said that as of June 20, it had been 14 months since the drugs were approved by the department’s Office of Operational Medicine.

Problems getting the medication from approval level to ground level were discovered during a larger OIG audit of the contract. Called a “management assistant report,” the OIG issued it “to provide early communication about a deficiency.”

Contributing to that deficiency was a lack of urgency.

Email traffic indicated Triple Canopy and State tried to get permission to import the medication between June and October last year. After that, the issued apparently was forgotten.

“Neither DS nor Triple Canopy has records later than October 2017 showing additional efforts to obtain the Government of Iraq’s approval to import the controlled medications,” the OIG report said.

Company representatives did not respond to a request for comment.

A bold face heading in the report is declarative: “DS Has Not Facilitated the Importation of Necessary Medications.”

The inspector general wanted to know what Bureau of Diplomatic Security officials did to assist Triple Canopy’s drug importation efforts. OIG reported that bureau officials said “that, beyond the diplomatic note in October 2017, DS has not pursued the matter further or attempted to negotiate with the Government of Iraq. Instead, DS officials added that they have been focusing on addressing Triple Canopy’s overall inability to secure adequate levels of staff. … DS officials reiterated that it is Triple Canopy’s responsibility to obtain the medications.”


That’s not good enough for severely injured Americans serving in dangerous posts abroad.